Oophorectomy slashes death risk in women with BRCA mutation

Women who carry a BRCA gene mutation and opt for a preventive oophorectomy have a 77% lower risk of death than those who do not, according to a study.

Research long has shown that preventive oophorectomy reduces the risks of ovarian and breast cancers in women with a BRCA gene mutation, but the best age for women to have the surgery and its impact on mortality has not been well-studied, according to background information in the study, which was published Feb. 24 on the website of the Journal of Clinical Oncology.

The findings by Amy Finch, MSc, PhD, Steven Narod, MD, and colleagues with Women’s College Hospital in Toronto are described as the first to look at these effects among a large cohort of women over a nearly six-year follow-up period.

“Scientific evidence clearly shows removal of a woman’s ovaries and fallopian tubes is very effective in preventing both breast and ovarian cancer in women with a BRCA mutation,” Finch, a researcher at Women’s College Research Institute and the study’s lead author, said in a news release. “But the real question has been at what age these women should have the surgery to best diminish their chance of developing cancer.”

The researchers evaluated the effect of a preventive oophorectomy in reducing death and the risk of ovarian, fallopian tube or peritoneal cancer in 5,783 women with a BRCA gene mutation.

“Our study supports the notion that women who carry a BRCA gene mutation will have a much lower risk of developing or dying from cancer if they have an oophorectomy at age 35,” Narod, a co-author of the study and senior scientist at Women’s College Research Institute, said in the news release.

The researchers found the surgery was associated with an 80% reduction in the risk of ovarian, fallopian and peritoneal cancer; a 77% lower risk of death from all causes; and a 68% lower risk of death from all causes in women who previously had breast cancer.

While oophorectomy is a safe procedure, it can carry some complications, including premature menopause. “After an oophorectomy, the long-term effects on a woman’s cardiovascular health and her bone health are less well known, and further research is needed,” Finch said.

Finch and Narod, along with colleagues from Women’s College Hospital and the University Health Network, are examining these potential effects in a new study to gain a better under-standing of the risks of a preventive oophorectomy for women with a BRCA mutation.

While the decision to undergo oophorectomy is life-altering, particularly for young women, these findings show the clear benefit of this surgery on cancer risk and mortality and will strengthen the recommendation for this surgery, the researchers said.